1. Field of the Invention
The present invention relates in general to a medical line securement device and, in particular, to a device that interconnects and releasably secures an elongated medical line to a neonate's skin.
2. Description of the Related Art
Premature babies usually require assistance to breathe and eat, and thus, are often fully instrumented. An endotracheal tube typically extends down the trachea of the neonate to supply oxygen to the lungs from a ventilation machine. These babies also are usually fed intravenously by an intravenous (IV) catheter inserted into a vein, usually on the dorsal side of the neonate's hand or forearm. In some cases, a naso-gastric tube may be inserted through the neonate's nose and used either for feeding/hydrating purposes or to drain gastric secretions. An arterial catheter may also be inserted on the ventral side of the neonate's hand for purposes of monitoring blood oxygenation.
The umbilical stump additionally is often catheterized. An umbilical catheter is inserted through the umbilical stump and is placed into the neonate's circulation system, with the assistance of fluoroscope or x-ray visualization, to precisely position the distal end of the catheter. The umbilical catheter allows medication to be directly introduced into the bloodstream and permits routine blood sampling, without having to frequently puncture the delicate skin of the neonate.
Each of these catheters and tubes is precisely positioned, and the position of each is fixed relative to the neonate to prevent migration or dislodgment. Healthcare personnel usually secure the IV, arterial and/or umbilical catheters using tape (and sometimes using sutures), and also fix the endotracheal and/or naso-gastric tube with tape. The catheters and tubes remain in place for several days or weeks, and often require repositioning and/or replacement on a periodic basis. The tape thus must be removed and reapplied to the neonate's delicate skin.
Tape often collects dirt and other contaminants. Normal protocol therefore also requires periodic tape changes to inhibit bacteria and germ growth at the securement site.
Frequent tape changes exfoliate the upper layers of the neonate's skin. Such exfoliation of the upper layers of skin can lead to abrasions on the neonate's skin because the neonate's skin is so thin, sensitive and fragile. Moreover, infection and disease can occur as a result of such skin wounds owing to the relatively undeveloped nature of a neonate's immune system.
Additional disadvantages exist with the use of tape to secure the catheters and tubes to the neonate. Valuable time of the healthcare provider is spent applying and reapplying the tape. Further, because most healthcare providers find such taping procedures difficult and cumbersome when wearing latex gloves, they often remove their gloves when taping. Not only does this further lengthen the taping procedure, but it also subjects the healthcare provider to possible infection. Moreover, even if the healthcare provider remains gloved, contact between the adhesive surface of the tape and the latex gloves causes micro-holes in the gloves, thereby degrading the integrity of the glove and subjecting the healthcare provider to possible infection.
A number of medical line securement devices have recently been developed that obviate the need for frequent application and removal of surgical tape and to removably secure the medical line to the patient. One such system is disclosed by U.S. Pat. No. 5,192,273 issued to the present Applicant. These systems, however, tend to be relatively large when used with neonates. A need thus exists for a medical line securement device particularly adapted for use with neonates that obviates the need for frequent application and removal of surgical tape.